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Thinking about Health Care

I try hard to stay away from politics in this blog. This is not an appropriate forum for taking sides or even expressing most opinions. I think, however, there is a fair exception in a general discussion about US health care. Whatever your views, we likely all agree that we have a complicated and troubled system that must be improved. There are a million ideas of ways to do that, but I suspect that all of us who have been touched by cancer have pretty strong feelings about the necessity of medical insurance coverage.

We come together with the belief that people with pre-existing conditions must be able to purchase decent, affordable insurance and that quality health care must be available for all Americans. This is a brief introduction to a really excellent article from The New Yorker by Atul Gawande. It is quite long, so pour yourself a cup of tea or coffee and settle in.

Is Health Care a Right?
It’s a question that divides Americans, including those from my home town. But it’s possible to find common ground.

Is health care a right? The United States remains the only developed country in the world unable to come to agreement on an answer. Earlier this year, I was visiting Athens, Ohio, the town in the Appalachian foothills where I grew up. The battle over whether to repeal, replace, or repair the Affordable Care Act raged then, as it continues to rage now. So I began asking people whether they thought that health care was a right. The responses were always interesting.

A friend had put me in touch with a forty-seven-year-old woman I’ll call Maria Dutton. She lived with her husband, Joe, down a long gravel driveway that snaked into the woods off a rural road. “You may feel like you are in the movie ‘Deliverance,’ ” she said, but it wasn’t like that at all. They had a tidy, double-wide modular home with flowered wallpaper, family pictures on every surface, a vase of cut roses on a
sideboard, and an absurdly friendly hound in the yard. Maria told me her story sitting at the kitchen table with Joe. She had joined the Army out of high school and married her recruiter—Joe is eleven years older—but after a year she had to take a medical discharge. She had developed severe fatigue, double vision, joint and neck pains, and muscle weakness. At first, doctors thought that she had multiple sclerosis. When that was ruled out, they were at a loss. After Joe left the military, he found steady, secure work as an electrical
technician at an industrial plant nearby. Maria did secretarial and office-manager jobs and had a daughter. But her condition worsened, and soon she became too ill to work.
“I didn’t even have enough energy to fry a pound of hamburger,” she said. “I’d have to fry half of it and then sit down, rest, and get up and fry the rest. I didn’t have enough energy to vacuum one room of the house.” Eventually, she was diagnosed with chronic-fatigue syndrome and depression. She became addicted to the opioids she was prescribed for her joint pains and was started on methadone. Her liver began to fail. In 2014, she was sent two hundred miles away to the Cleveland Clinic for a liver-transplant evaluation. There, after more than two decades of
Maria’s deteriorating health, doctors figured out what the problem was: sarcoidosis, an inflammatory condition that produces hardened nodules in organs throughout the body. The doctors gave her immunosuppressive medication, and the nodules shrank away. Within a year, she had weaned herself off the methadone.